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Clinical presentation and outcomes of COVID-19 in older hospitalised patients assessed by the record-based multidimensional prognostic index, a cross-sectional study
- Source :
- European Geriatric Medicine, Verholt, A B, Gregersen, M, Gonzalez-Bofill, N, Hansen, T K, Ebdrup, L, Foss, A-C H & Lietzen, L W 2021, ' Clinical presentation and outcomes of COVID-19 in older hospitalised patients assessed by the record-based multidimensional prognostic index, a cross-sectional study ', European Geriatric Medicine, vol. 12, no. 6, pp. 1147-1157 . https://doi.org/10.1007/s41999-021-00522-3
- Publication Year :
- 2021
-
Abstract
- Key summary points Aim Confusion was more prevalent in frail than in non-frail older patients at hospital admission. Finding COVID-19 and accelerated functional decline were associated among frail older hospitalised patients when compared to non-frail. Message Ninety-day all-cause mortality was 70% among frail hospitalised patients with COVID-19 and 15% among non-frail.<br />Purpose Older people are the most frequently hospital admitted patients with COVID-19. We aimed to describe the clinical presentation of COVID-19 among frail and nonfrail older hospitalised patients and to evaluate the potential association between frailty and clinical course, decision of treatment level with outcomes change in functional capacity and survival. Methods We performed a multi-center, retrospective cross-sectional cohort study examining data on clinical presentation and frailty-related domains for hospitalised people aged 75 + years with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test. Frailty was assessed at admission using record-based MPI (rMPI) and Clinical Frailty Scale (CFS). Decision on treatment level about invasive ventilation and cardiopulmonary resuscitation (CPR), change in CFS-score from admission to discharge, changed need of home care, and in-hospital, 30-day and 90-day mortality were registered. Results 100 patients (median age 82 years (IQR 78–86), 56% female) with COVID-19 were included. 54 patients were assessed moderately or severely frail (rMPI-score = 2 or 3) and compared to non-frail (rMPI-score = 1). At admission, frail patients presented more frequently with confusion. At discharge, functional decline measured by change in CFS and increased home care was more prevalent among frail than the non-frail. Decisions about no invasive ventilation or CPR were more prevalent among frail older patients with COVID-19 than non-frail. Ninety-day mortality was 70% among frail patients versus 15% in non-frail. Conclusion Frailty seems to be associated with confusion, more frequent decisions about treatment level, larger functional decline at discharge and a higher mortality rate among older patients with COVID-19.
- Subjects :
- Male
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Cross-sectional study
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
medicine.medical_treatment
health care facilities, manpower, and services
03 medical and health sciences
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Cardiopulmonary resuscitation
Aged
Retrospective Studies
Geriatrics
Aged, 80 and over
030214 geriatrics
Frailty
business.industry
SARS-CoV-2
Mortality rate
COVID-19
Prognosis
Cross-Sectional Studies
Emergency medicine
Female
Presentation (obstetrics)
business
human activities
Cohort study
Research Paper
Subjects
Details
- ISSN :
- 18787649
- Volume :
- 12
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- European geriatric medicine
- Accession number :
- edsair.doi.dedup.....57da20cfed9c694dc5114f6b00041604